Physical Therapy of Parkinson's Disease Patient With Lateral Trunk Flexion due to Dystonia

Abstract

  The patient was a female in her 60's with Parkinson's disease. She had lateral trunk flexion, which was suspected to be caused by drug-induced dystonia with Pramipexole. Even one month after withdrawal of the drug, the condition didn't improve. Therefore, physical therapy was initiated. Chief complaints were pain of the left trapezius and erector spine, and inability to walk for a long time. Dystonia of oblique muscles caused lateral trunk flexion. Lateral trunk flexion caused the secondary pain of left trapezius and erector spine for compensation. Physical therapy using a sling was carried out to practice relaxation of the right oblique muscles and contraction of the right erector spine without conpensation of the left side. Standing position and gait training were done shoe height on the right side. After 7 months, pain of the left trapezius and erector spine dissapeared during rest and housework. Gait duration increased to over 1 hour. QOL (SF-36) was improved on all of 8 scores.